{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T04:38:40Z","timestamp":1793335120684,"version":"4.5.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T00:00:00Z","timestamp":1564444800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Contemporary research suggests that transgender and gender-nonconforming (TGNC) adults encounter formidable barriers to health care, including access to quality therapeutic interventions. This systematic review is one of the first to specifically explore obstacles to TGNC mental health care. A rigorous literature review identified eight relevant studies: six qualitative designs and two quantitative designs. Thematic synthesis revealed three major barriers to care and five corresponding subthemes: (1) personal concerns, involving fear of being pathologized or stereotyped and an objection to common therapeutic practices; (2) incompetent mental health professionals, including those who are unknowledgeable, unnuanced, and unsupportive; and (3) affordability factors. Results indicate an acute need for practitioner training to ensure the psychological well-being of TGNC clients.<\/jats:p>","DOI":"10.1093\/hsw\/hlz016","type":"journal-article","created":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T15:13:12Z","timestamp":1559229192000},"page":"149-155","source":"Crossref","is-referenced-by-count":113,"title":["Barriers to Mental Health Care for Transgender and Gender-Nonconforming Adults: A Systematic Literature Review"],"prefix":"10.1093","volume":"44","author":[{"given":"Annie","family":"Snow","sequence":"first","affiliation":[{"name":"Constance Wilson Professorship in Mental Health, College of Social Work, University of Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Cerel","sequence":"additional","affiliation":[{"name":"Constance Wilson Professorship in Mental Health, College of Social Work, University of Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane N","family":"Loeffler","sequence":"additional","affiliation":[{"name":"Constance Wilson Professorship in Mental Health, College of Social Work, University of Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Flaherty","sequence":"additional","affiliation":[{"name":"Constance Wilson Professorship in Mental Health, College of Social Work, University of Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,7,29]]},"reference":[{"key":"2019120807571244000_ref1","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"2013","edition":"5th ed."},{"key":"2019120807571244000_ref2","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1037\/a0039906","article-title":"Guidelines for psychological practice with transgender and gender nonconforming people","volume":"70","author":"American Psychological Association.","year":"2015","journal-title":"American Psychologist,"},{"issue":"1","key":"2019120807571244000_ref3","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1080\/08952833.2013.755081","article-title":"Seeking support: Transgender client experiences with mental health services","volume":"25","author":"Benson","year":"2013","journal-title":"Journal of Feminist Family Therapy,"},{"key":"2019120807571244000_ref4","doi-asserted-by":"publisher","first-page":"264","DOI":"10.17744\/mehc.31.3.f62415468l133w50","article-title":"The experiences of transgendered persons in psychotherapy: Voices and recommendations","volume":"31","author":"Bess","year":"2009","journal-title":"Journal of Mental Health Counseling"},{"key":"2019120807571244000_ref5","doi-asserted-by":"publisher","first-page":"943","DOI":"10.2105\/AJPH.2013.301241","article-title":"Stigma, mental health, and resilience in an online sample of the US transgender population","volume":"103","author":"Bockting","year":"2013","journal-title":"American Journal of Public Health"},{"key":"2019120807571244000_ref6","volume-title":"Transforming qualitative information: Thematic analysis and code development","author":"Boyatzis","year":"2009"},{"key":"2019120807571244000_ref7","doi-asserted-by":"publisher","first-page":"1820","DOI":"10.2105\/ajph.2012.300796","article-title":"Experiences of transgender-related discrimination and implications for health: Results from the Virginia Transgender Health Initiative Study","volume":"103","author":"Bradford","year":"2013","journal-title":"American Journal of Public Health"},{"key":"2019120807571244000_ref8","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1037\/sgd0000167","article-title":"Affirmative practice with transgender and gender nonconforming youth: Expanding the model","volume":"3","author":"Edwards-Leeper","year":"2016","journal-title":"Psychology of Sexual Orientation and Gender Diversity,"},{"key":"2019120807571244000_ref9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta7010","article-title":"How important are comprehensive literature searches and assessment of trial quality in systematic reviews? 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